Brain tryptophan hydroxylase: purification of, production of antibodies to, and cellular and ultrastructural localization in serotonergic neurons of rat midbrain. Tryptophan hydroxylase [EC 1.14.16.4; L-tryptophan, tetrahydropteridine:oxygen oxidoreductase (5-hydroxylating)], the enzyme catalyzing the rate-limiting step in the biosynthesis of serotonin, was purified 79-fold from the region of the raphe nucleus of rat midbrain by sequential column chromatography and disc-gel electrophoresis. In electrophoresis three bands were distinguished, A, B, and C, which, when separated and submitted individually to electrophoresis, reproduced the same three bands. Bands A and C were enzymatically active and inhibited by para-chlorohenylalanine. Antibodies produced to each of the three bands crossreacted by immuno double diffusion and electrophoresis with each other and homogenates of raphe nuclei; they completely inhibited enzyme activity only of tryptophan hydroxylase. Tryptophan hydroxylase was localized by light and electron immunohistochemistry to serotonin neutrons of the raphe. Ultrastructurally, in cell bodies, the enzyme was distributed in cytoplasm and in association with endoplasmic reticulum and Golgi apparatus. In dendrites and axons, it was associated with microtubules. Tryptophan hydroxylase in brain is only neuronal and cytoplasmic, exists in multiple forms, and is associated with microtubules, suggesting it may be transported from sites of synthesis in cell body into axons.


Receptor synapses without synaptic ribbons in the cochlea of the cat. This report describes recepto-neural junctions thought to be chemical synapses without synaptic ribbons or vesicle aggregates. Such synapses occur in the cat between the outer hair cells of the cochlea and auditory nerve fibers. These synapses are formed by flat or indented junctions having symmetric membrane complexes associated with smooth endoplasmic reticulum and coated vesicles in the outer hair cell cytoplasm. Inner hair cells have receptoneural junctions with asymmetric membrane complexes; synaptic ribbons and vesicles gather at one type of junction, while the other type associates with endoplasmic reticulum. Gap junctions are not seen at cochlear synapses but do link supporting cells. The results suggest that inner and outer hair cell synapses have different properties and raise questions about the role of synaptic vesicles and endoplasmic reticulum in the storage and release of transmitters.


Hemoglobin Cranston, an unstable variant having an elongated beta chain due to nonhomologous crossover between two normal beta chain genes. An asymptomatic woman was found to have a compensated hemolytic state due to an unstable hemoglobin variant, comprising 35% of the total. Peptide maps of tryptic digests of the abnormal beta chain were identical to those of beta A except that tryptic peptide 15 (Tyr-His-COOH) was absent and a new peptide was detected, containing equivalent amounts of Ser, Ile, Thr, and Lys. Its sequence was determined by manual Edman degradation. An additional hydrophobic peptide isolated by counter-current distribution contained: Asx, Ser, Ala, Tyr, 2 Phe, and 3 Leu. Its sequence was determined on an automatic solid phase sequencer. Digestion with carboxypeptidase A confirmed the C-terminal sequence. Hemoglobin Cranston has an elongated beta chain with the following structure: (see article). This variant is the first "adult" human hemoglobin known to contain isoleucine. It is likely that hemoglobin Cranston arose because of a nonhomologous crossover of two normal beta chain genes, probably during meiosis, with the insertion of two nucleotides (AG) at position 144, resulting in a frame shift. Hemoglobin Cranston provides new information on the structure of the beta chain gene as well as an explanation of both the structure and genetic basis of hemoglobin Tak, the only other elongated beta chain variant that has been described.


Nucleotide sequences of the 3'-terminal untranslated region of messenger RNA for human beta globin chain. In normal messenger RNA for the human beta-globin chain, nucleotide sequences have been identified which can be matched to the amino-acid sequence of the abnormally long segment of the beta-chain of hemoglobin Cranston. The finding of these sequences strengthens the hypothesis that the betaCranston chain arose by a frameshift mutation allowing the "readthrough" of the normal termination codon and translation of usually untranslated portions of the messenger RNA for the beta-globin chain. The oligonucleotides which match the amino-acid sequence of hemoglobin Cranston provide a sequence of 36 nucleotides which follows the normal beta-chain termination codon UAA.


Normal genetically mosaic mice produced from malignant teratocarcinoma cells. Malignant mouse teratocarcinoma (or embryonal carcinoma) cells with a normal modal chromosome number were taken from the "cores" of embryoid bodies grown only in vivo as an ascites tumor for 8 years, and were injected into blastocysts bearing many genetic markers, in order to test the developmental capacities, genetic constitution, and reversibility of malignancy of the core cells. Ninety-three live normal pre- and postnatal animals were obtained. Of 14 thus far analyzed, three were cellular genetic mosaics with substantial contributions of tumor-derived cells in many developmentally unrelated tissues, including some never seen in the solid tumors that form in transplant hosts. The tissues functioned normally and synthesized their specific products (e.g., immunoglobulins, adult hemoglobin, liver proteins) coded for by strain-type alleles at known loci. In addition, a tumor-contributed color gene, steel, not previously known to be present in the carcinoma cells, was detected from the coat phenotype. Cells derived from the carcinoma, which is of X/Y sex chromosome constitution, also contributed to the germ line and formed reproductively functional sperms, some of which transmitted the steel gene to the progeny. Thus, after almost 200 transplant generations as a highly malignant tumor, embryoid body core cells appear to be developmentally totipotent and able to express, in an orderly sequence in differentiation of somatic and germ-line tissues, many genes hitherto silent in the tumor of origin. This experimental system of "cycling" teratocarcinoma core cells through mice, in conjunction with experimental mutagenesis of those cells, may therefore provide a new and useful tool for biochemical, developmental, and genetic analyses of mammalian differentiation. The results also furnish an unequivocal example in animals of a non-mutational basis for transformation to malignancy and of reversal to normalcy. The origin of this tumor from a disorganized embryo suggests that malignancies of some other, more specialized, stem cells might arise comparably through tissue disorganization, leading to developmental aberrations of gene expression rather than changes in gene structure.


Transposition of R factor genes to bacteriophage lambda. Transpositions of segments of R factor (antibiotic resistance plasmids) to bacteriophage lambda have been selected and characterized. Cells of Escherichia coli harboring R factors that determine kanamycin resistance were infected with phage lambda, and lambdakan transducing lines were obtained. Each of the three examined is unusual when compared to lambda transducing phages containing E. coli chromosomal genes: the kan insertions (a) occur at several sites, each well removed from the integration region POP', (b) are not associated with deletion of lambda phage DNA, and (c) are separable from the lambda genome during transduction or during lytic growth. Two insertions from the same R factor contain 1.5 kilobase sequences repeated in inverted order. The properties of the lambdakan phage suggest that R factors contain systems capable of mediating genetic exchange in the absence of extensive DNA homology. It is suggested that such systems of exchange may have played important roles in R factor evolution.


Relationship between nuclear and cytoplasmic poly(adenylic acid). The kinetics of accumulation of radioactive poly(A) in the nucleus and cytoplasm of mouse L cells have been determined using labeling conditions in which the cellular ATP pool is shown to have a nearly constant specific radioactivity. Most or all nuclear poly(A) accumulates with kinetics very similar to those of heterogeneous nuclear RNA, having a half-time of about 25 min. There is little or no lag before attainment of a maximal rate of accumulation of cytoplasmic poly(A). These data are consistent with a variety of models in which nuclear poly(A) does or does not all serve as a precursor of cytoplasmic poly(A). In either type of model there must be a class of poly(A) either synthesized in the cytoplasm or passing through a small nuclear pool separate from the main pool of nuclear poly(A).


Analysis of incipient reproductive isolation within a species of Drosophila. Drosophila willistoni and its subspecies quechua are morphologically indistinguishable, but differ in relative frequencies of certain allozyme genes. The cross quechua female X willistoni male produces nearly or completely sterile males, while the reciprocal cross gives fertile males. Hybrid females are fertile. Analysis of the sterility with the aid of chromosomes marked with mutant genes shows that the second and X-chromosomes have major and third chromosomes minor effects. Backcross males of the same chromosomal constitution may be either fertile or sterile; the threshold effect may be due to environmental variations or to gene variants present in the strains crossed. Only a trace of ethological isolation between the subspecies is present. In contrast to a narrowly localized and geographically isolated subspecies bogotana of D. pseudoobscura, the subspecies quechua of D. willistoni is fairly widespread, although its geographic area is not accurately known. Neither with bogotana nor with quechua are there valid reasons to suppose that these subspecies are of very recent origin.


A mechanism for initiation of genetic recombination. A mechanism for the initiation of genetic recombination is proposed. Its key features are the pairing, nicking, and cross-annealing of palindromic loops, i.e., structures formed by DNA with sequences of inverted complementary repeats. This mechanism may provide a simple, yet specific means of producing crossed strand connections between homologous DNA duplexes to form structures which can be intermediates in the process of genetic recombination.


Expression of the beta-thalassemia gene in the first trimester fetus. To determine whether beta-thalassemia can be detected in the fetus, blood was obtained from abortuses of normal mothers and of mothers with beta-thalassemia trait. The red cells were incubated with radioactive leucine and the globin chains were analyzed by radiochromatography. Two independent methods were utilized to correct the results for contamination by maternal radioactive beta-chain, and the corrected beta/gamma ratios were compared to a previously established range of normal fetal beta/gamma synthetic ratios obtained by similar measurements in pure fetal cells. In the erythroid cells of three fetuses from mothers with beta-thalassemia trait, the beta/gamma synthetic ratio was normal in two. The third had a beta/gamma ratio of 0.04 at 10 1/2 weeks, a 50% reduction, consistent with fetal beta-thalassemia trait. Two other fetuses, derived from parents both of whom had beta-thalassemia trait, were also studied. One had a beta/gamma ratio of 0.029 at 8 weeks, a 65% reduction, also consistent with beta-thalassemia trait. The cells of the other had a ratio of essentially zero at 11 weeks, highly suggestive of homozygous beta-thalassemia. Although further experience will be needed to distinguish the homozygous and heterozygous states reliably, it now appears that the beta-thalassemia gene is expressed in the first trimester. Therefore these data suggest that the antenatal diagnosis of beta-thalassemia is becoming an attainable goal.


Mutants of T7 bacteriophage inhibited by lambda prophage. Mutants in gene 20, a new T7 gene, cannot grow on rex+ lambda lysogens. Gene 20-- mutants suppress in double mutants the phenotype of T7 ligase negative mutations, but not vice versa. Amber 20- mutants have been obtained. There are differences between these T7 mutations and the similar T4 rII mutations. There are host mutations which permit T7 20- mutants to grow on lambda+ lysogens. T7 DNA synthesis on normal lambda+ lysogens infected with 20- mutants is essentially normal, but the DNA is not packaged. The gene 20 protein is active in in vitro complementation and probably used late in infection for DNA packaging into phage heads.


Selection for conditional gametogenesis in Chlamydomonas reinhardi. A new technique is described for selection of temperature-sensitive mutants affecting gametogenesis in Chlamydomonas reinhardi. The first mutant found by this technique is characterized. Cells exhibiting the gam-1 phenotype are capable of sexual agglutination, but cannot form zygotes at the restrictive temperature. The mutation, however, has been expressed only in gametes of mating type (-). Cells of mating type (+) which carry this gene are able to engage in normal zygote formation. Temperature shift experiments and antibiotic studies have indicated that this gene is expressed within 6 hr after the onset of gametogenesis in liquid culture, and its product has a lifetime of about 4 hr at 35 degrees.


Synthesis of hemoglobin AIc in normal and diabetic mice: potential model of basement membrane thickening. Adult diabetic mice (C57Bl/KsJ--db/db) have increased amounts of a minor hemoglobin in their peripheral blood compared to wild-type (+/+) mice. This increase is analogous to the 2-fold increase of a glycohemoglobin with similar chromatographic mobility (Hb AIc) seen in the blood of patients with diabetes mellitus. Although the exact chemical nature of human or mouse Hb AIc is unknown, both contain a sodium-borohydride-reducible linkage on the beta chain which is a presumed Schiff base between a sugar moiety and the protein. The db/db animals, which have normal amounts of mouse Hb AIc at weaning, show the increase approximately 4 weeks after the onset of the signs of diabetes. This rise is brought about by an increase in a circulating factor that determines directly or indirectly the synthesis of mouse Hb AIc as a post-synthetic modification of Hb A. Evidence for this was obtained by showing that the rate of synthesis of the modified Hb is linear for at least the first 50 days of the life of the red cell and that the rate of synthesis is dependent on the environment in which the cells circulate. Thus the rate of mouse Hb AIc synthesis in +/+ cells is greater when those cells circulate in a db/db host than when they circulate in a +/+ host. The nature of the humoral factor is unknown. If glycosylations of basement membrane proteins and hemoglobin proceed via a common mechanism, then the monitoring of Hb AIc could provide a useful model for studying the early events of basement membrane thickening.


[13C]Valine metabolism in methylmalonicacidemia using nuclear magnetic resonance: propinonate as an obligate intermediate. [Alpha-13C]- and [alpha,beta-13C]valine were administered sequentially to a patient with methylmalonicacidemia to clarify the metabolic pathway of valine from methylmalonic acid semialdehyde to methylmalonyl-CoA. Methylmalonic acid was isolated from multiple urine samples, purified, and analyzed by 13C nuclear magnetic resonance spectroscopy. Contrary to the widely accepted view, the results show unequivocally that methylmalonic acid semialdehyde is decarboxylated to propionate before conversion to methylmalonyl CoA.


Complementation of H-2-linked Ir genes in the mouse. The immune response to the random linear terpolymer of L-glutamic acid, L-lysine, and L-phenylalanine (GLphi) is under dominant H-2-linked Ir gene control in the mouse. Matings between two nonresponder strains produced responder F1 hybrids, demonstrating complementation of the nonresponder alleles. This observation, coupled with the fact that several intra H-2 recombinant strains derived by recombination between two nonresponder parental haplotypes are also GLphi responders, indicated at least two dominant loci are concerned with responsiveness to this terpolymer. The complementary genes were termed alpha (tentatively localized in a new subregion of the H-2 complex, I-F) and beta, which maps in the I-A subregion. Generally, both the alpha(+) and beta(+) alleles are required for responsiveness. However, in the (C57BL/6J X SJL)F1 hybrid we noted complementation between two parental nonresponder strains, each of which carried beta genes derived from different H-2 haplotypes, yet lacked functional alpha genes. The possible cell levels at which these genes may function in the regulation of the immune response are discussed.


Rapid changes in rat pineal beta-adrenergic receptor: alterations in l-(3H)alprenolol binding and adenylate cyclase. The properties of the beta-adrenergic receptor which regulates adenylate cyclase [ATP pyrophosphate-lyase (cyclizing)8 EC 4.6.1.1] in the pineal gland are similar to the properties of the sites which specifically bind l-[3H]alprenolol, a potent beta-adrenergic antagonist. Stimulation of the beta-adrenergic receptor results in a 30-fold increase in the activity of N-acetyltransferase (= arylamine acetyltransferase; acetyl CoA:arylamine N-acetyltransferase, EC 2.3.1.5), an enzyme involved in the synthesis of thepineal hormone melatonin. In the normal diurnal light-dark cycle there is greater physiological stimulation of the beta-adrenergic receptor in the pineal during the night than during the day. Pineals from rats kept in constant light for 24 hr possess more hormone-sensitive adenylate cyclase and specifically bind more l-[3H]alprenolol than do pineals from rats kept in the dark overnight. When rats, exposed to light for 24 hr, are treated with the beat-adrenergic agonist isoproterenol, there is a rapid loss of both hormone-sensitive adenylate cyclase activity and specific l-[3H]alprenolol binding sites. There is no change in the affinity of adenylate cyclase for isoproterenol or for its substrate, ATP. Similarly, although there are fewer binding sites, there is no change in the affinity of the remaining sites for either agonist or antagonist. Inhibition of protein synthesis with cycloheximide does not affect the loss of either adenylate cyclase activity or specific binding sites. The data suggest that stimulation of the beta-adrenergic receptor causes a rapid decrease in the number of available receptors and in hormone-sensitive adenylate cyclase activity; conversely, lack of stimulation causes an increase in these parameters. It is suggested that these changes contribute to the phenomena of super- and subsensitivity in the pineal gland by regulating the capacity of the pineal to synthesize cyclic AMP in response to beta-adrenergic stimulation.


Mating signal and DNA penetration deficiency in conjugation between male Escherichia coli and minicells. Strain OU122, a dnaB mutant of HfrH which stops vegetative DNA synthesis immediately when the temperature is shifted to 43 degrees, was mated at 43 degrees with minicells with and without 1 mM Zn2+. Synthesis of DNA was detected in the mating mixture containing minicells derived from either Fchi925 or F+chi115 cells, but only a small amount was detected in the mixture containing 1 mM Zn2+ which inhibits the formation of mates (previously called mating pairs). The supernatant liquid from cell cultures did not induce DNA synthesis, suggesting that DNA synthesis was not stimulated by diffusible molecules. Additional experiments showed that Zn2+ inhibited DNA synthesis associated with DNA transfer but did not inhibit the DNA transfer that had already been initiated. Thus, the stimulation of DNA synthesis observed required physical interaction of cells and F pili. Reisolated minicell exconjugants derived from the cross OU122 X F--chi925 minicells were shown to contain transferred DNA in contrast to either the cross OU122 X F--chi925 minicells in 1 mM Zn2+, or the cross OU122 X F+chi1115 minicells. Thus, F+chi1115 minicells retained the property of surface exclusion at 43 degrees.


Control of meal size by central noradrenergic action. Previous investigations of central noradrenergic effects on food intake have concentrated on the use of high doses of noradrenaline (two to 200 times brain noradrenaline content). In this work we examined the effect of low doses of noradrenaline (not exceeding brain noradrenaline content) on the parameters of spontaneous ingestive behavior. By arranging for rats to trigger remote infusions of noradrenaline into their own anterior forebrains at the beginning of spontaneously initiated meals, meal size was very reliably increased more than 200% by doses of 0.015--0.37 nmol (2.5--62 ng of noradrenaline base) (n = 12). The effect was alpha-adrenergic. It was blocked by phentolamine but not by propranolol. Infusions of noradrenaline at the above doses, which nearly triple meal size, did not elicit eating when made during an intermeal interval, nor did they influence the length of the intermeal interval when made 60 min after the termination of an uninfused meal. These results show that noradrenaline increased food intake at doses less than 1% of the brain's endogenous noradrenaline content. Meal size is more susceptible to alteration by noradrenaline manipulations than is meal frequency.  The brain's own noradrenergic system may function to sustain food intake once feeding is initiated. This function of brain noradrenaline may control spontaneous meal size.


Group selection, altruism, reinforcement, and throwing in human evolution. Evolution of altruism by group selection involves sacrifice of some individuals, not to the "group as a whole," but to other individuals in the group. Deme-group selection may establish strictly altruistic genes in a population, but only under limited conditions, and perhaps never among vertebrates, among which apparently altruistic behaviors may always potentially benefit the altruists. Responsive-group selection is a more effective mode of evolution of altruism, conspicuous in man. Evolutionary reinforcement increases the force of selection of advantageous behaviors, including altruistic ones, by making them pleasant or rewarding. It is probably involved also in ecological habitat selection, and may be the source of many human emotions, including esthetic ones. Throwing (of stones and weapons) exemplifies both the possible importance of a difficult-to-measure evolutionary factor and the role of reinforcement; in human evolution throwing may have been decisive in food-getting and fighting, in shifting emphasis from brute force to skill, and in inducing evolution of a brain able to handle three-body geometric problems precisely and thus preadapted for more complex functions.


An effect of castration and testosterone replacement on a circadian pacemaker in mice (Mus musculus). Castration of mice in freerunning conditions (total darkness, DD) causes a reduction of running wheel activity in the beginning of the active period (alpha) and stimulates activity at the end of alpha. Simultaneously, the period (tau) of the freerunning rhythm is increased. Both effects are abolished by implantation of a Silastic capsule from which a physiological dose of testosterone is released at a constant rate. The results are tentatively explained by differential endocrine influences on two oscillating components in the pacemaker of the circadian activity rhythm.


The dentist and the patient. Restoration of a severely devastated mandibular dentition after the elimination of all focal infections and periodontal inflammation.


Orthodontic self-treatment, a morphological and psychological curiosity.


Cranio-skeletal morphology for a segment of the black urban population using sella nasion as a cranial base line.


Occupational science and dental practice administration. I.


Basic emergency kit.

Basic emergency kit.


Growth and spontaneous remission of a tumor--a nine-year observation. Clinical diagnosis: epulis gigantocellularis.


Ultimate life time expectation of amalgam restorations in the Netherlands.


The solution of prosthetic problems.

The solution of prosthetic problems.


The Dalbo resilient hinge joint.

The Dalbo resilient hinge joint.


Parafunctions related to trigeminal neuralgia.


Occupational science and dental practice administration. II.


Instant photographs as rational information and documentation sources.


New horizons for dentistry in a changing world.


Expanded osteoma in the region of the processus muscularis.


Narcotics. I.

Narcotics. I.


The incorporated millimeter grid in oral roentgenography.


An ergonomic patient instruction system for orthodontic appliances.


Narcotics. II.

Narcotics. II.


Resection of the mandible and functional restoration through transplant of bone taken from the pelvic crest.


Treatment of anterior teeth for aesthetic problems.


Ultrasonic laminagraphy of the temproromandibular joint.


Preventive orthodontics for Indians and Eskimos.


Narcotics. III.

Narcotics. III.


Beginning with the last--the omega experience.


Applied hypnosis: a case report.

Applied hypnosis: a case report.


Extensive unilateral hypertrophy of the left side of the mandible, with formation of exostoses.


A system for dental practice hygiene.

A system for dental practice hygiene.


Removal of foreign body in root canal.

Removal of foreign body in root canal.


Direct-indirect technique for crown construction on vital teeth.


Use of retentive pins in composite restorations. Class IV.


Unusual cases from an orthodontic practice. I.


Oral surgery and radiation therapy.

Oral surgery and radiation therapy.


Debridement with ultrasonics. I.

Debridement with ultrasonics. I.


Psycho-social study of outstanding female athletes.


Relationship between erectores spinae voltage and back-lift strength for isometric, concentric, and eccentric contractions.


Arm-positioning accuracy as a function of direction, extent, and presentation.


Comparison of the personality traits of female teacher education and physical education students.


Prediction of maximal oxygen intake in preadolescent boys from anthropometric parameters.


Effect of puberty on reaction and movement times.


Responses of the composition of body fat to cardiovascular training in college women.


An aerobics conditioning program for the Fort Worth, Texas School District.


Multidimensional scaling and factor analysis of coaching behavior as perceived by high school hockey players.


An electromyographic investigation of the sartorius and tensor fascia latae muscles.


Performance outcomes of cross-country running structured in a voluntary activity class.


Attitudinal differences in two types of physical education programs.


Cross sex effects of subject and audience during motor performance.


Interaction analysis of physical education classes.


Objectives of physical education expressed as needs by university students.


A sequential timing device.

A sequential timing device.


Effect of target color on throwing accuracy.


Cytoenzymochemical effects of some antiblastic drugs and prediction of response to chemotherapy in acute leukemias. Over 20 cytoenzymochemical tests were carried out in 152 patients with different types of acute leukemia to estimate the effects of some antiblastic drugs such as L-asparaginase, Purinethol, Methotrexate, Endoxan, Vinchristine, Cytosine Arabinoside a.o. The patients selected for the study were carefully examined before treatment at different moments during and/or at the end of the treatment. The effects of these drugs on the blast cells were mild when the cellular populations had a low rate of nucleic acid synthesis, high glycogenic score and high amounts of lipids or an important oxidative enzymatic activity. The enzymatic prediction tests: the acid phosphate deviation test and the succinic dehydrogenase inhibition test including the variant suggested by some of the authors - the latic dehydrogenase inhibition test - gave satisfactory results only in certain cases of acute leukemia.


Folate studies. Folate and vitamin B12 values in relation to bone marrow pattern.


Thymidine kinase activity in human bone marrow cells. The thymidine kinase activity per 10(6) DNA-synthesising marrow cells and the rate of incorporation of tritiated thymidine into the DNA of 10(3) DNA-synthesising marrow cells were estimated in 9 haematologically normal patients and 49 patients suffering from a variety of haematological disorders. Slight increases in thymidine kinase activity were found in 6 of the 31 patients with haematological diseases associated with normoblastic erythropoiesis and greater increases were found in 3 of the 18 patients with megaloblastic haemopoiesis due to vitamin B12 or folate deficiency. In the latter group, there was a statistically significant inverse correlation between haemoglobin levels and thymidine kinase activity. No correlation was found between thymidine kinase activity and the rate of incorporation of tritiated thymidine in either the normoblastic or megaloblastic group, suggesting that the level of thymidine kinase activity does not limit the rate of incorporation of exogenously supplied thymidine into the DNA of human bone marrow cells.


Needle biopsy in diffuse lung manifestations. An analysis of 145 consecutive cases.


Problem solving in diagnostics and therapeutics of neurology. A series of 24 lectures. Lecture No. 2. Bedside diagnostix.


Compartment syndromes.

Compartment syndromes.


Differentiation of erythroleukemic cells in the presence of inhibitors of DNA synthesis. Erythroid differentiation can be readily induced by butyric acid in cultured erythroleukemic cells in the presence of inhibitors of DNA synthesis and in the absence of cell division. This result appears to rule out more complex models for globin gene expression which require gene replication or cell division (or both).


Incontinentia pigmenti (Bloch-Sulzberger syndrome) associated with acute granulocytic leukemia. Incontinentia pigmenti, a syndrome of developmental defects, was found to be associated with acute granulocytic leukemia in a 4-month-old black girl. She has been responsive to antileukemic drugs, and remission has been induced without difficulty after each relapse. Although survival time was expected to be very short because of her age, race, type of leukemia, and initial peripheral leukocyte count at time of diagnosis, she is still alive 35 months after diagnosis of leukemia. One may speculate that the prolonged survival time might be related to the unknown genetic defect.


Methods for instrumentally checking recorded relationship between the positions of the upper and lower jaws.


Compressive strength of dental amalgam.

Compressive strength of dental amalgam.


Emergency procedures in intoxications.

Emergency procedures in intoxications.


Hospital associated infections in surgical patients.


Successful pregnancy following repair of a ruptured uterus.


Carotid sinus syncope: its diagnosis and management.


Alpha-methyldopa-induced immune hemolytic anemia.


Office curettage.

Office curettage.


Trends in medical education.

Trends in medical education.


Localized dissecting aneurysm of the aorta: a clinicopathological study.


For physicians, a secondary occupational concern.


Bee sting anaphylaxis.

Bee sting anaphylaxis.


Minor tooth movement--a preventive measure.


Presence of the dentist: a stress evoking cue?


Combat years on ship forged crew's bond.


"A survey of the nutritional component of dental practice in the state of Virginia".


Dental students conduct preventive dentistry programs.


The bitter pill: socialized medicine in Britain.


Breast disease. A clinical study with special reference to diagnostic procedures. A consecutive series of 1.310 women with breast complaints and a control group of 241 healthy women were examined by clinical examination and mammography. The majority of the palpable and non-palpable lesions were preoperatively classified on a four-point scale according to the degree of suspicion of malignancy. A similar classification was performed after mammography as well as after aspiration biopsy. Some aspects of the case-histories including a positive family history of breast carcinoma, marital status and breast feeding were studied in women with breast complaints and compared to the findings in a control group of women. Previous breast disease, mode of detection, delay and breast symptoms were also studied...


Comments on prophylactic treatment for febrile convulsions.


Prediction of recovery in Bell's palsy.

Prediction of recovery in Bell's palsy.


Electron microscopic observations of the utricle and ampullae in a case of dizziness of suspected saccular origin. Electron microscopic observation was reported on the utricle and ampullae of a case, a 36-year-old male, with dizziness attack due to suspected saccular origin. After the removal of the utricle and ampullae, the dizziness recurred, and finally the saccular nerve section relieved the dizziness attack of this case. So the actual lesion was localized in the saccule and was not in the specimens obtained at the first surgery. Though most of hair cells appeared normal, there were a few with many vacuoles or shrinkage of the cytoplasm distributing sparsely throughout the sensory epithelia. The distribution of the pathological hair cells in the utricle was more general than in the ampullae. The sensory hair cells without pathology and the presynaptic structures were similar to those found in the experimental animals. Nerve and nerve endings showed normal structures. The findings may be physiological at this age group or an extension of the pathology of the dizziness-causing lesion.


On fibrinolysis in reproduction.

On fibrinolysis in reproduction.


Transition of nystagmus types in unilateral labyrinthine diseases. In order to clarify changes in spontaneous and positional nystagmus which occurred during the course of peripheral labyrinthine diseases, 31 patients with Ménières disease (17 cases), aural vertigo of unknown etiology (9 cases), and sudden deafness (5 cases) were tested repeatedly using ENG. The testing of each case was made 4.8 times on the average with an average interval of 7.2 days. Twenty-four cases (77.4%) showed more than two of the following four types which are listed in serial order of occurrence: spontaneous (or direction-fixed positional) nystagmus toward the involved ear; geotropic direction-changing positional nystagmus; spontaneous (or direction-fixed positional) nystagmus toward the opposite ear; and apogeotropic direction-changing positional nystagmus. Thus, the above-mentioned order may be regarded as the uniform pattern in the nystagmus transition caused by acute unilateral labyrinthine diseases.


Tubing, as a treatment for recurrent infant suppurative otitis media. (1) The details described below have evidenced that the tubing therapy is an influential treatment for the recurrent infant suppurative otitis media. The tube with a beveled head and split shank is very convenient and effective for the treatment since it is not only easily inserted but also easily removed, preventing it from migration into the tympanum. (2) The treatment must promote the drainage of discharges through the infant auditory tubes which are thick and short and improve the ventilation of the middle ear cavity half permanently. (3) According to the author's experience, the spontaneous extrusion of the ideally set tube after 2 or 3 months is a sign of a perfect cure of this disease.


Positional alcoholic nystagmus (PAN) in man following repeated alcohol doses.


Responses of cortical vestibular center produced by stimulation of vestibular nuclei and visual association area in the cat. (1) The cortical projection of the vestibular nuclei (LVN, MVN and IVN) was investigated by the evoked potential and unit discharge analyses in the cat anesthetized with alpha-chloralose and/or immobilized with gallamine triethiodide. (2) This projection field coincided well with that of the vestibular nerves, being principally contralateral by LVN stimulation but nearly symmetrical by either MVN or IVN stimulation. (3) Of 11 units responsive to vestibular nuclei stimulation, 6 reacted to stimulation of the visual association cortex (anterior part of the Clare-Bishop area). The response pattern of the cortical vestibular units by C-B stimulation was a sequence of excitation, inhibition and rebound. (4) Interaction of visual information with the cortical vestibular neurons was discussed.


Optic organ and cervical proprioceptors in maintenance of body equilibrium. Two experiments were made on the functional correlation between the optic organ and the cervical proprioceptors in maintenance of body equilibrium. Experiment I: The effects of weak and strong electric stimulation of the deep nuchal muscles on changes in optokinetic nystagmus and optokinetic after-nystagmus were examined in adult non-albino rabbits with binocular vision. Experiment II: Experiment I was repeated on rabbits with monocular vision giving optokinetic stimulation moving from the side of the blindfolded eye to that of the open eye and applying only weak electric stimulation to the neck muscles. The results obtained were as follows: (1) Experiment I: Weak electric stimulation of the deep nuchal muscles of rabbits with binocular vision tended to promote optokinetic nystagmus with either no significant change or decrease in optokinetic after-nystagmus. Strong electric stimulation had the opposite effects, i.e., it tended to inhibit optokinetic nystagmus and activate optokinetic after-nystagmus. It also produced abnormal optokinetic nystagmus, such as the inversion phenomenon of optokinetic nystagmus and "optokinetic nystagmus firing". (2) Experiment II: Weak electric stimulation of the deep nuchal muscles of rabbits with monocular vision had similar effects to those in experiment I, but promotion of optokinetic nystagmus was less obvious, while activation of optokinetic after-nystagmus was more marked. In addition, the inversion phenomenon of optokinetic nystagmus developed even on weak electric stimulation. From these results the following conclusions were drawn: (1) The cervical proprioceptors can function in two mechanisms causing promotion and break down of equilibrium of the optokinetic system. (2) The cervical proprioceptors, as an organ of equilibrium, can exert two different actions on the optokinetic eye reflexes, i.e., they can promote optokinetic nystagmus and inhibit optokinetic after-nystagmus.


A quantitative test of optokinetic nystagmus and its data processing by computer. A quantitative test of optokinetic nystagmus was proposed. Horizontal nystagmus was examined by a large rotating cylinder with vertical stripes. Nystagmus responding to the cylinder rotation with an acceleration of 2 degrees/sec2 for 90 seconds was recorded with an electronystagmograph. On the records, the number of beats, average eye-speed, and average amplitude per each 10 seconds were calculated. This method was suitable for testing the nature of optokinetic nystagmus which indicates the ability of the eyes to adapt to objects moving through the visual field. Moreover, in order to save trouble in hand-scoring of each parameter of nystagmus, computer processing of electronystagmographic data was introduced. The results were printed numerically on the teletypewriter, and displayed graphically on a cathode ray tube and X-Y recorder. By displaying measured values on the form already printed with the normal ranges, the evaluation of the results was performed readily and objectively.


Neurotological studies on the role of the sympathetic nervous system in the formation of traumatic vertigo of cervical origin. To test the validity of the hypothesis that irritation of the cervical sympathetic nerves is a cause of hypertonicity of the cervical soft supporting tissues, especially the deep nuchal muscles, and that this hypertonicity is a cause of traumatic vertigo of cervical origin, we examined 44 vertigo cases with whiplash injury by testing equilibrium function and EMG discharges from the neck before and after administration of drugs affecting the sympathetic receptors. The results obtained were as follows: 1. Administration of iso-proterenol (beta-receptor stimulant) caused a significant increase in the EMG's from the injured neck muscles, in parallel with increased impairment of the righting reflex. The blindfolded vertical writing test showed the appearance or intensification of ataxia or deviation in writing when this drug was given. In contrast, administration of propranolol (beta-receptor depressor) had the opposite effects on the EMG's, the righting reflex and blindfolded vertical writing. Furthermore, the resulting changes in the EMG's and equilibrium functions were parallel with alterations in subjects' complaints, i.e., increase or decrease in neck pain and vertigo. 2. Administration of drugs affecting the alpha receptors, such as noradrenaline (alpha-receptor stimulant) and phentolamine (alpha-receptor depressor) had no appreciable effect on the EMG's, equilibrium function or the subjects' complaints. These results show that in vertigo due to whiplash injury hypertonicity of the cervical erector muscles can be induced sympathetically, and that this hypertonicity is based on over-excitement of beta receptors in the injured neck muscles, which results in vertigo of cervical origin.


Simultaneous application of electronystagmography (ENG) and photoelectronystagmography (PENG) in the case of thermal labyrinth examination. At examination of normal persons, the ENG registration method was compared with that of PENG. Special examinations were executed with regard to the behaviour of the beat rates during the culmination phase of thermal labyrinth reactions by using each of both registering methods. By synchronous recording of PENG and ENG, it was possible to settle the discrepancy of the greater number of beats in ENG compared with those of PENG, while the examinations were executed at different times. The PENG-method does not exclude an optical fixation due to the necessary interior illumination, and this results in a retarding of the reaction and smaller beat rates. This fact should be considered when comparing the results of ENG and PENG.


Lumbomuscular proprioceptive reflexes in body equilibrium. To evaluate the role of reflexes related to the lumbar proprioceptors in maintenance of body equilibrium, changes in equilibrium function of the eyes and body were observed after unilateral procainization of the lumbar erector muscles. Observations were made on normal subjects and vertigo cases with lumbar pain after whiplash injury using various equilibrium tests. The results obtained were as follows: (1) On unilateral procainization of the lumbar erector muscles of normal subjects, eye nystagmus and disturbances of the righting reflex developed. Simultaneously, changes in drift reactions of the lower limbs were detected by the stepping test. Namely, in many of the subjects examined the direction of stepping deviation became quite different from that before procainization, and stepping after procainization tended to show slight or moderate ataxic features, associated with a sensation of unsteadiness. (2) When procaine was injected unilaterally into tender spots in the lumbar erector muscles of traumatic vertigo cases, spontaneous eye nystagmus and disturbances of the righting reflex decreased. Simultaneously, significant changes in the drift reactions of the lower limbs were observed in many of the cases examined. Namely, the direction of deviation became the opposite of that before procainization and ataxia in walking almost disappeared with reduction in vertigo. The following conclusions were drawn from these findings: (1) The effects of procaine on equilibrium of normal subjects are in sharp contrast to its effects on equilibrium of traumatic vertigo cases. Findings in the former might be due to increased imbalance between the activities of the right and left lumbar proprioceptors, while those in the latter might be due to decreased imbalance between the two. (2) These findings support the view that from the standpoint of body equilibrium, there are two phases of the proprioceptive reflex, and that Fukuda's concept of "two phases of the labyrinthine reflex, i.e., a stage of disturbance and a stage of coordination", can be applied to interpretation of the proprioceptive reflex of lumbar origin.


The effect of gravity on galvanic nystagmus in rabbits. The effect of gravity on a galvanic nystagmus provoked in rabbits was investigated. Weightlessness increased the amplitude but decreased the frequency as well as the speed of the nystagmus. During continuous galvanic stimulation the provoked nystagmus disappeared spontaneously after a period of 60-120 seconds. Weightlessness was able to arouse this nystagmus again. An explanation of this phenomenon might be that galvanic nystagmus undergoes a modifying effect from the vestibular maculae and their state of stimulation.


Postural behavior and motion sickness.

Postural behavior and motion sickness. (1) An interesting style of acting was demonstrated on a stage of a Kyogen, a classic comedy of Japan, titled "Funawatashimuko", i.e., "A boatman and a bridgegroom in a boat". Antagonistic postures which move toward the opposite direction were displayed by a boatman who is pulling an oar and a passenger who is being moved by the rolling of a boat. (2) Why doesn't one suffer from motion sickness when he drives a car but may suffer from it when he is a passenger? This question was answered, from the standpoint of human postures, by observing the antagonistic postures exhibited by a bus-driver and a passenger, and also by the findings in postrotatory eye nystagmus (an indication of artificial motion sickness) which was varied according to the three different positions of the head. (3) Learning postural adjustment against motion sickness, developing through repetitively traveling in vehicles, was also objectively shown in a posture of an experienced lady bus-conductor whose body inclined in the same direction as that of the driver. Its similarity to the establishment of a kinetic labyrinthine reflex in chickens was explained.


Serum lysozyme activity in children with hematological and malignant disorders. Pretreatment serum lysozyme activity was high in 2 children with myelomonocytic leukemia, 800 and 1 000 mug/ml, normal in all 10 cases of acute lyelocytic leukemia and subnormal in 21 of 34 cases of acute lymphocytic leukemia. Normal values were found in all but one case of acute lymphocytic leukemia during complete remission including 8 cases after all therapy had been discontinued. All 8 are still in complete remission. Low serum lysozyme activity was found in 5 patients with acute lymphocytic leukemia in complete relapse, this could possibly be helpful in the diagnosis of early relapse. Activity was subnormal in 5 of 17 children with malignant tumours, and in 3 of 65 cases of various benign hematological disorders.


Tissue culture of the organ of Corti and the isolated hair cells from the newborn guinea pig. The organ of Corti and isolated hair cells from newborn guinea pig were cultured with the Rose chamber method. The hair cells could be maintained for more than 20 days after explantation when the organ of Corti was cultured as a whole, though the isolated hair cells swelled and degenerated within about 13 hours after explantation. By comparison between the tissue culture of the hair cells with the organ of Corti and isolated hair cell culture, the following conclusions were reached: (1) There are some functional correlations concerning the nutritional requirements and cell metabolism between the hair cells and the supporting cells in addition to the structural correlations. (2) There are no distinct fundamental differences between both inner and outer hair cells about their affectability as a single cell level.


Incidence of chronic renal insufficiency. A study of the incidence and pattern of renal insufficiency in adults during 1966-1971 in Gothenburg.


Liposarcoma a clinicopathologic, radiographic and prognostic study. The present investigation is a clinicopathologic, radiologic and prognostic study of 122 liposarcomas registered in the Swedish Cancer Registry between 1958 and 1966. The incidence of liposarcoma in Sweden was estimated to be 2.5 cases per million inhabitants per year. The liposarcomas were divided into 4 main subtypes according to WHO's recommended classification (1969): well-differentiated (33 cases), myxoid (22 cases), rundcell (14 cases) and pleomorphic types (21 cases). When predominantly well-differentiated or myxoid liposarcomas contained areas of round-cell or pleomorphic types (24 and 8 cases, respectively), they were classified separately, thus adding 2 further subtypes to our classification. The validity of this histologic classification was emphasized by the prognostic study, based on a 10 year follow-up. The differential diagnosis for each of the 4 main subtypes is discussed. Three well-differentiated, lipoma-like liposarcomas which contained highly vascular hibernoma-like areas are described. Two well-differentiated liposarcomas situated in the neck and upper part of the back, respectively, of elderly patients included area similar to "spindle-cell lipoma" (Enzinger). An intracytoplasmic network of birefringent fibers with the staining reaction of collagen was found in 2 well-differentiated fibrosing liposarcomas...


Meningeal leukemia in the blastic phase of chronic granulocytic leukemia. One hundred one patients were treated for Ph' positive chronic granulocytic leukemia (CGL) in the blastic phase. In seven of these (6.9 per cent), meningeal leukemia developed. Of the 99 patients who died of their disease, a complete remission was achieved in 12 with a median survival of 12 months (three to 28 months). Incomplete responders had a median survival of only 2.5 months (one to 14 months). In five of the 12 complete responders (42 per cent), but in only two of the incomplete responders (2.3 per cent), meningeal leukemia developed. The principal neurologic signs were cranial nerve palsies and papilledema. All patients had pleocytosis with myeloblasts in the cerebrospinal fluid. As in patients with acute leukemia and diffuse histiocytic lymphoma, increased survival of patients in whom hematologic remission from the blastic phase of CGL is achieved may allow sufficient time for the development of meningeal leukemia. Intrathecal methotrexate is extremely successful in treating this complication. Cerebrospinal fluid pleocytosis was eradicated in all seven of our patients, and neurologic symptoms and signs were completely eliminated in five patients. No evidence of meningeal leukemia was found in three of the five patients in whom an autopsy was performed.


Nonextraction treatment of class II, division 1 malocclusion with the Begg technique.


The class II malocclusion: differential diagnosis and clinical application of activators, extraoral traction, and fixed appliances. The importance of an exact differential diagnosis of the Class II malocclusion and its indications for treatment with activators, extraoral forces, and fixed appliances has been shown. Four schematized malocclusions with their cephalometric characteristics and their individualized orthopedic therapeutics have been presented. Special attention has been given to the subsequent fixed mechanotherapy showing the limited need for fixed appliances. This approach is attractive, for it reduces considerably the stress imposed on the patient and the orthodontist, it bypasses the iatrogenic hazards entailed in extensive and prolonged mechanotherapy, and it consistently increases chances for long-term stability.


Remodeling of teeth by grinding.

Remodeling of teeth by grinding. Pulp and dentin reactions to extensive grinding of human teeth were studied clinically and histologically. The facial portions of forty-eight premolars to be extracted for orthodontic reasons were reshaped to "lateral incisors" using diamond instruments and abundant water cooling. Following grinding and polishing with sandpaper discs and pumice, topical fluoride was administered. The patients were asked to report any increased sensitivity reactions. The teeth were extracted at 0, 1, or 3 weeks or 3 to 5 months and examined histologically. No significant discomfort was reported by the patients except for an initial period of a few days during which there was increased sensitivity to temperature changes. The histologic findings indicated that extensive remodeling of young permanent teeth is possible with no or only minor pulp and dentin reactions. Some initial localized effects in terms of aspiration of odontoblast nuclei, hyperemia, absence of a cell-free zone, and slight cellular infiltration were sometimes observed, but the long-term observations indicated that these reactions were transient. Secondary dentin formation was not registered. It is important that gentle grinding techniques with abundant water spray be used and that smooth and self-cleansing surfaces which allow hypermineralization of the ground enamel and dentin be prepared. In a few teeth in which proximal retention areas were unintentionally prepared, caries developed and marked pulp reactions occurred. Therefore, great care must be taken not to introduce proximal steps when mesiodistal tooth width adjustments are performed. The present study has provided histological and clinical evidence to indicate that even extensive recontouring by grinding may not be harmful to the teeth. This should encourage orthodontists to remodel teeth by grinding to improve the final occlusal and esthetic results in a number of different cases.


Hyoid positioning during deglutition following forced positioning of the tongue.


The irregularity index: a quantitative score of mandibular anterior alignment. A quantitative method of assessing mandibular anterior irregularity is proposed. The technique involves measurement directly from the mandibular cast with a caliper (calibrated to at least tenths of a millimeter) held parallel to the occlusal plane. The linear displacement of the adjacent anatomic contact points of the mandibular incisors is determined, the sum of the five measurements representing the Irregularity Index value of the case. Reliability and validity of the method were tested, with favorable results. At the University of Washington, several clinical studies have been and are continuing to be performed, using this technique as one of several methods of assessing pretreatment status and posttreatment change. It is hoped that this article will aid the reader in understanding the rationale and utility of a simple quantitative tool which could be used in malocclusion assessment.


The American Board of Orthodontics announces specific instructions for certification.


Editorial: The third party wants to know.


New perspectives on orientation and their benefits to clinical orthodontics - part I. The historical development of cranial reference lines, basic to cephalometric orientation, was discussed. The evolution to, away from, and back again to the Frankfort horizontal plane for descriptive and communicative purposes as benefits to the clinical orthodontist was explained. Objectives were set forth as a basis for selecting the most appropriate method in orienting the headplate for measurement and assessment. The major functions of cephalometrics were pointed out to be its use for description or classification of the face together with the malocclusion and for superimpositioning for longitudinal comparison. Each of these purposes calls for particular requirements pointing to the need for combinations of planes and multisuperimposing. The statistical findings via a computer pointed to the use of the Frankfort plane as the most desirable basic reference for descriptive reasons. Composites also suggested good order from Frankfort horizontal when serial tracings were compared. It was emphasized that true porion was used, not the ear rod of the cephalometer. For growth analysis the basion-nasion plane was shown to be longitudinally of superior value for chin behavior.


Comparative analysis of changes resulting from bite plate therapy and Begg treatment. This study was based on a cephalometric study of 82 children composed of three groups: the first group treated with a flat anterior bite plate, the second group subject to the Begg therapy, and an untreated control group. The object of this study was to investigate changes in the dentofacial complex which occur as a result of bite plate therapy compared with Begg treatment. It was found that the short term changes as a result of bite plate therapy were associated with an increase in the height of the upper and lower molars. The long term changes as a result of bite plate therapy were associated with a significant increase in the height of the molars and some increase in lower incisor height. Lower facial height showed a significant increase in dimension. During Begg treatment it was found that short term changes in the dentofacial complex were associated with a significant increase in the height of the lower molars and a significant reduction in the height of the lower incisors. The long term changes of Begg therapy were associated with a significant increase in the height of the lower molars and some increase in lower facial height.


Activity of temporal and masseter muscles in children with a lateral forced bite. The activity of the temporal and masseter muscles with the mandible in postural position and during chewing, maximal bite in the intercuspal position, and swallowing were recorded electromyographically in nineteen children with laterally forced bite. Of the children, aged 8-12 years, sixteen had unilateral crossbite. In all of the individuals there was lateral deviation between the retruded contact position and the intercuspal position. The magnitude of the lateral deviation was measured with a modified gnathothesiometer. The muscle activity was recorded bilaterally from the temporal muscle and from the masseter muscle. In the postural position asymmetric activity was found in the temporal muscle suggesting that the mandible in postural position was still displaced to the side of forced bite. During chewing the activity was asymmetric both in the anterior and the posterior temporal portions. This asymmetric muscle activity was interpreted as an adaptation to avoid cuspal interferences. Also in maximal bite the muscle activity was asymmetric, while the activity during swallowing was affected less than in the other functions. The swallowing activity was, however, less in children with a forced bite than in children with normal occlusion.


Soft-hard tissue correlations and computer drawings for the frontal view. Hard and soft tissue measurements were obtained for nine Caucasian women. Based on these measurements, regression formulas were derived to approximate the soft tissue covering based on hard tissue data. The results are presented iconically by computer drawings. The preliminary data presented would suggest a definite predictable influence exerted by the facial skeleton on the position of landmarks in the overlying soft tissue.


Multiple extraction patterns in severe discrepancy cases. Thirty-five cases have been collected from colleagues which illustrate that removal of additional maxillary teeth, following first bicuspid extractions, can allow the successful resolution of difficult discrepancy and anchorage cases. Charts 1 and 2 describe the amounts of space that might be expected by removal of additional upper bicuspids, upper first molars, and upper second molars. The findings on upper second molars are admittedly limited. Anchorage values as expressed by an efficiency percentage were approximately what would be expected from a study of anchorage values of the roots of teeth. The removal of upper second bicuspids has a better anchorage efficiency potential than the upper first molar, but this may be overcome somewhat by the greater size of the molar. Clear guidance cannot be given as to which teeth to remove in a specific case, but it is the observation of the author that for cases that are still in full Class II following four bicuspid space closure, upper second bicuspid removal would be more helpful from an anchorage perspective, whereas for cases that are in end-to-end molar relationship or require only a few millimeters to move into Class I, the upper first molar might be the tooth of choice. Also, the supper first molar removal allows for a more "normal" appearing arch assuming normal alignment and size of the upper second and third molars. The comparison with the nonextraction control group showed an enormous difference in the amount of incisor retraction that extractions provide when related to the maxilla. The nonextraction control group, though experiencing dramatic correction of Class II relationships, showed no incisor movement within the maxilla. Some problems which appeared in the sample were described. Removal of upper teeth in addition to the four first bicuspids can be a solution to an occasional anchorage, skeletal, growth or cooperation problem.


The role of mandibular plane inclination in orthodontic diagnosis.


Follow-up respiratory function of a patient treated with a membrane lung. A patient in remission from acute lymphoblastic leukemia developed the adult respiratory distress syndrome. Despite "optimal respiratory therapy" and ventilatory assistance with 100 per cent inspired O2 (fraction of inspired O2 = 1) and 15 cm of positive end-expiratory pressure, the patient's arterial PO2 remained at 33 mm Hg. Prepulmonary venovenous respiratory support was given for 10 days with a spiral coil membrane lung. The data document the sequential improvement in respiratory function and suggest that despite the severe lung damage that may occur during the adult respiratory distress syndrome treated with prolonged high inspired concentration of O2, if the patient's lungs recover from the acute process, the respiratory system can recover so that there is little, if any, permanent restriction of the subject's activities as a result of respiratory impairment.


Uprighting impacted mandibular second molars.


Evolution of the Nation's Ocean Program.


Synthesis and reaction of some 6-substituted pyrimidine nucleosides. Treatment of 5-bromouridines with sodium cyanide afforded 6-cyanouridines. Further treatment of the 6-cyano derivatives with cyanide ion at higher temperature gave the 5-cyanouridines. The 6-cyano group was transformed to thioamido, carboxy, chloromethyl cyanomethyl, carboxymethyl, and methyl group, respectively. 5-Bromocytidines were also converted to the 6-cyanocytidines, from which cytidine 6-carboxylic acid was derived. The cyano group of 6-cyanocytidines has a leaving ability toward nucleophilic substitution reactions. The circular dichroic spectra of various 6-substituted pyrimidine nucleosides showed positive Cotton effect at B2u region, which were in contrast to the reported negative bands in 6-methyl-uridine or-cytidine.


Synthesis and evaluation of acyclic sugar nucleosides. Acylated aldose dialkyl dithioacetals with bromine undergo replacement of one alkylthio group by bromine. These unstable bromides react, as by fusion with 2,4-bis(trimethylsilyloxy)pyrimidine, to give acylated 1-(pyrimidin-1-yl) derivatives that upon saponification afford acyclic sugar nucleoside analogues, some as separable mixtures of 1-epimers. Systemic stereochemical variants have been conducted. Pmr conformational studies show that the sugar chain is extended in certain examples, whereas others favor folded ("sickle") conformations, in line with a general rationale developed for acyclic-sugar derivatives. Condensation of the bromides with purines gives 9-substituted acyclic-sugar nucleoside analogues; synthesized systematically for various series, these include the D-pentoses in combination with 6-mercaptopurine. In vitro and in vivo biological activities vary according to stereochemistry of the sugar. The position of substitution of the sugar chain, the chirality at C-1', and the tautomeric form of the heterocycle, were established by x-ray crystallography of the product from D-arabinose and 6-mercaptopurine. The x-ray data permit correlation of C-1 chirality throughout the series and pmr data indicate the favored conformations.


Synthesis and biological activity of some nucleosides resembling guanosine: imidazo(1,2-alpha)pyrimidine nucleosides.


The determination of anomeric configuration of D-ribofuranosyl nucleosides by PMR spectroscopy.


Synthesis of certain 4'-substituted nucleosides. We have developed general methods for the synthesis of 4'-fluoro- and 4'-methoxynucleosides by addition of iodinemonofluoride or iodine and methanol across the double bond of suitably protected 4',5'-unsaturated pyrimidine and purine nucleosides. The structures of these adducts have been determined by a combination of chemical, spectroscopic, and electrophoretic methods. The 4'-methoxy- and the uridine analogs of nucleocidin have been synthesized from the corresponding 4'-fluorouridine and 4'-methoxyadenosine derivatives.


Experimental and clinical studies on nucleoside analogs as antitumor agents.


Nucleoside analogs in the treatment of nonneoplastic diseases.


Cytokinins as chemotherapeutic agents.

Cytokinins as chemotherapeutic agents.


Physiological distribution of 2,2'-anhydro-1-beta-D-arabinofuranosyl-5-fluorocytosine (AAFC) in man.


The effects of nucleoside analogs on cutaneous neoplasms.


Occurrence of deaminated monophosphate nucleotide in extracellular sites after giving arabinofuranosylcytosine or deoxycytidine to mice.


Further considerations in the therapy with ara-C.


Nucleoside analogs in the treatment of neoplastic and nonneoplastic diseases.


The utilization of nucleotides by animal cells. We have extended our studies on the toxicity of several arabinosyl nucleotides to L cells. In contrast to a short-term toxic effect of 9-beta-D-arabinofuranosyladenine (araA), both 9-beta-D-arabinofuranosyladenine 5'-phosphate (araAMP) and 9-beta-D-arabinofuranosyladenine 3',5'-cyclic phosphate produced sustained killing of the fibroblasts. 9-beta-D-Arabinofuranosyladenine 2',5'-cyclic phosphate and 9-beta-D-arabinofuranosyladenine-N1-oxide-5'-phosphate were not toxic, whereas 9-beta-D-arabinofuranosylhypoxanthine 5'-phosphate and adenosine 3',5'-cyclic phosphate had relatively slight effects on cell growth. 2',3'-Dideoxyadenosine 5'-phosphate was lethal to L cells, whereas 2',3'-dideoxyadenosine inhibited growth only slightly. The survival time of mice bearing Ehrlich ascites carcinoma was prolonged beyond controls equally well by treatment with either araAMP or araA. To explore the mechanism of nucleotide toxicity, we studied the metabolism of exogenous [3H, 32P]-araAMP. The double-labeled compound entered the cells very slowly and accumulated in both acid-soluble and acid-insoluble materials. 32P and 3H were associated with the adenine nucleotide fractions in ratios similar to that of the exogenous compound. After dephosphorylation of the acid-soluble fraction, greater than 85% of the 3H was associated with araA. Following degradation of the adenine-containing triphosphates with apyrase, all of the 32P and 97% of the 3H were associated with araAMP. Only small quantities of each label were associated with RNA and DNA. Following enzymatic degradation of DNA to 5'-monophosphates, most of both 3H and 32P were associated with the dAMP fraction in a ratio that was similar to that of the exogenous araAMP. After dephosphorylation of the 5'-monophosphates, greater than 90% of the 3H was contained in arabinosyl nucleosides. DNA was also enzymatically degreded to 3'-monophosphates. 3H was found primarily in the 3'-adenine nucleotide fraction with a slight amount in the nucleoside, whereas 32P was distributed among all the 3'-mononucleotides. After dephosphorylation of the 3'-monophosphates, 93% of the 3H was associated with araA. These results indicate that a small amount of araAMP penetrated the cell as the intact nucleotide, was phosphyorlated to the triphosphate and was subsequently incorporated within DNA.


The synthesis and evaluation of azapurine nucleosides as cytotoxic agents.


Synthesis and biological activity of some novel analogs of thymidine.


Efficacy of ribavirin against influenza virus in tissue culture and in mice.


Biochemical pharmacology of a new thiopurine nucleoside derivative.


The biosynthesis of the nucleoside antibiotics: minimycin formation by Streptomyces hygroscopicus.


Transport of nucleosides.

Transport of nucleosides.


Effects of nucleoside analogs on purine nucleotide metabolism.


Biochemistry and biological effects of the pyrazofurins (pyrazomycins): initial clinical trial.


Cardiovascular effects of nucleoside analogs. Short-chain aliphatic esters and amides of adenosine-5'-carboxylic acid caused marked increases in coronary sinus oxygen tension (PO2) in the dog; the amides were generally more potent, causing additionally marked hypotension and tachycardia. The hypotensive effect was observed also in the spontaneously hypertensive rat. That the increase in coronary sinus PO2 paralleled an increase in coronary flow was verified with ethyl adenosine-5'-carboxylate hydrochloride. This compound also increased the reactive hyperemic response. Aminophylline blocked the increase in coronary flow. A representative amide and ester were very poor substrates for adenosine and adenylate deaminase in vitro; the amide exhibited a weak inhibitor effect on the enzymic activities while the ester was inactive. The observations that the compounds (1) cause marked pharmacological effects within seconds after intravenous administration, (2) are blocked by aminophylline like adenosine, (3) are not deaminated significantly in vitro by either adenosine or adenylate deaminase, and (4) cannot be phosphorylated at the 5' terminus because the 5'-OH has been removed chemically, support the hypothesis that they are acting directly on an "adenosine receptor" and have a prolonged duration of action because they are not metabolized significantly by the normal physiological pathways of adenosine degradation.


Biochemical properties of 5-sulfur-substituted pyrimidine nucleosides and nucleotides.


Natural modified nucleosides and chemical carcinogenesis: L-ethionine-dependent inhibition of N6-dimethyladenosine and 5-methylcytidine synthesis on the tRNA level in vivo.


Mechanisms of halogenated nucleoside embryotoxicity.


The use and regeneration of type-O canisters for protection against methyl bromide.


Synthesis of nucleosides with use of trimethylsilyl-heterocycles.


Nucleosides. XCI. Some chemical properties of the antileukemic agent 2,2'-anhydro-1-beta-D-arabinofuranosyl-5-fluorocytosine.


Synthesis, chemical reactivity, and chemotherapeutic activity of certain selenonucleosides and nucleosides related to the pyrrolo(2,3-d)pyrimidine nucleoside antibiotics.


Radiation problems in a strong magnetic field.


Gingivostomatitis syndrome: current etiologic considerations and report of two cases.


Inside a dental clinic of the Boys' Club of New York.


Experiences with vagotomy in the treatment of gastroduodenal ulcer. Special reference to early results and to recurrent post-vagotomy ulcer.


Are you aware that ...

Are you aware that ...


Organ irradiation and combination chemotherapy in treatment of acute lymphocytic leukaemia in children. Lanzkowsky, P., Shende, A., Aral, I., Saluja, G. (1975). Archives of Disease in Childhood, 50, 685. Organ irradiation and combination chemotherapy in treatment of acute lymphocytic leukaemia in children. A total of 30 consecutive children with acute lymphocytic leukaemia (ALL) were treated from June 1971 until December 1974. Remission was induced with the use of vincristine and prednisone. After induction of remission, cranial irradiation and intrathecal methotrexate were given. Then the liver, spleen, and kidney were irradiated and 6-mercaptopurine, cyclophosphamide, and methotrexate were administered during the maintenance phase. Pulsed doses of vincristine and prednisone were administered at 10- to 12-week intervals. The patients were subdivided into two groups based on their initial white blood cell (WBC) counts: a standard risk group with an initial WBC count of less than 25 000/mm3 (25 X 10(9)/1) and a high risk group with an initial WBC count greater than 25 000/mm3 (25 X 10(9)/1). Of the 30 children entered in this study one standard risk patient died in the induction phase before attaining remission. Analysis of the results is therefore based on the remaining 29 patients, 22 standard risk and 7 high risk patients, who attained complete remission. Survival rates in continuous remission were found to be 43% of the high risk group, 88% for the standard risk group, and 77% for the combined group. Analysis of the data indicates that this therapy is unsatisfactory in high risk ALL. The results to date of this therapy for standard risk are sufficiently encouraging to continue its use in this subgroup of patients.


Production and properties of bacteriocins (mutacins) from Streptococcus mutans.


Light and electron microscopic study of liquefaction degeneration in oral lichen planus.


Determination of trace elements in surface enamel of human teeth by a new biopsy procedure.


Migration of fibroblasts in the periodontal ligament of the mouse incisor as revealed by autoradiography.


A sialochemical study on patients with Sjögren's syndrome.


The relationship between the secretion of amylase and epidermal growth factor in the mouse submandibular salivary gland.


Carabelli's trait on maxillary second deciduous molars and first permanent molars in Hindus.


Glycolytic intermediates in Streptococcus mutans PK 1.


Arterial embolectomy in the lower limbs. A series of arterial embolectomies of the lower limb is reviewed, and the results are compared with those in a previous series reported from this hospital. There were 40 emboli in the 36 patients, with an operative mortality of 16% and a limb salvage rate of 85%. This represents a considerable improvement on the results reported from the first series and is attributed to the greater experience of surgeons with the Fogarty embolectomy catheter. However, there has been no decrease in the delay between the onset of symptoms and the embolectomy. If this aspect of management could be improved, then even better results should be obtained.


Unilateral painful vasospasm in the lower limbs of young women. The cases of five young women who presented with severe pain and associated vascular changes in one foot are described. The pain was spontaneous in onset and lasted for days, and its severity was such that none of the patients were able to walk without disability. Arteriography in three patients revealed arterial spasm. All had a good response from lumbar sympathectomy on the affected side.


A comparison of the supraclavicular and axillary approaches to upper thoracic sympathectomy. Twenty-nine upper dorsal sympathectomies have been carried out in 18 patients and a comparison made of the supraclavicular with the axillary approach to the upper thoracic sympathetic chain. Thirteen of these operations were carried out for essential hyperhidrosis, 15 for ischaemia in the hand and one for post-traumatic pain syndrome. Fourteen sympathectomies were carried out through the axilla and 15 through the supraclavicular approach. Post-operative pain was felt to be somewhat more severe when the axillary approach was used, but other complications were infrequent and hospital stay was slightly shorter in the axillary group. The axillary approach was felt to offer superior exposure, the capability for wider sympathetic excision, good cosmetic results, avoidance of Horner's syndrome and low morbidity. In the absence of lung disease or the need for a direct exploration of the root of the neck, the axillary approach is to be preferred for upper dorsal sympathectomy.


Subvalvular left ventricular aneurysm following mitral valve replacement. Two cases are presented which represent different aspects of damage to the posterior wall of the left ventricle following mitral valve replacement. In the first case rupture of the ventricle occurred in the immediate postoperative period with a fatal result, while in the second, delayed aneurysm formation occurred with embolic and haemodynamic complications. This patient also did not survive. A review of the literature reveals four similar cases previously recorded. Possible aetiological factors are considered, including operative trauma, ischaemic damage, rupture of unsupported muscle, previous surgery with the development of pericardial adhesions and fixing of the valve ring, and finally abscess formation. The indications for operative intervention and possible complications of the aneurysm are noted.


Diaphragmatic rupture with cardiac tamponade. Intrapericardial herniation of abdominal viscera following blunt abdominal trauma is rare. We have been able to find only nine reported cases. Six of these were finally diagnosed after a long delay, ranging from a year to 23 years. Three were diagnosed within three months of the original injury, but in these patients, the investigations were initiated following an abnormal chest skiagram. We wish to report a unique case in which a traumatic intrapericardial hernia presented as an acute cardiac tamponade within 48 hours of injury.


Upper limb emboli: a reappraisal.

Upper limb emboli: a reappraisal. Upper limb embolus cannot be regarded as a benign condition, with invariable recovery due to copious collateral circulation. Gangrene of the upper limb may occur, as shown in the series of cases in this report. The overall mortality rate remains considerable, because of associated cardiac disease, recurrent embolism, or both. Emboli proximal to the origin of the profunda brachii artery represent a group associated with higher risk, for which prompt embolectomy is often indicated. In embolism due to subclavian aneurysm and with thrombosis, arterial reconstruction should be undertaken, for multiple recurrence is likely. Long-term anticoagulant therapy is usually required to try to prevent recurrence of embolism if the primary source of the embolus remains.


Malignant pulmonary haemangiopericytoma.


Dolichocolon.

Dolichocolon. A plea is made for the recognition of a disorder of the colon, commonly encountered in the elderly, which is characterized by elongation (and also by dilatation) of the colon, especially the sigmoid. It may give rise to symptoms which suggest a diagnosis of carcinoma. The condition is believed to be acquired, and is an important aetiological factor in the development of sigmoid and, less frequently, of caecal volvulus.


Pancreatitis following intestinal bypass for obesity. Three out of 24 patients undergoing intestinal bypass in the treatment of morbid obesity have developed acute pancreatitis in the postoperative period. All three had undergone end-to-end jejunoileal bypass. This serious postoperative complication has been infrequently recorded. Its significance and possible aetiological factors are discussed.


Experiences with appendicostomy old and new.


Carcinoma of the oesophagus: preoperative irradiation followed by planned resection for lesions in the middle and lower thirds--an interim report. Since 1968, at the Thoracic Surgery Unit in the Royal Perth Hospital, a combined approach of preoperative deep X-ray therapy and excisional surgery has been adopted for patients with potentially operable carcinoma of the oesophagus. This has produced an improvement in the survival time for middle third lesions when compared with the result previously obtained following unaided surgical excision. The method is described, and the early results are indicated.


Gastric carcinoma : an unusual presentation.


Hot nodules of the thyroid gland.

Hot nodules of the thyroid gland.


Nodular goitre in northern India : a clinicopathological profile.


Gallstone erosion of the aorta.

Gallstone erosion of the aorta. A case of fatal erosion of the abdominal aorta by gallstones is reported. The patient presented with a six-day history of melaena and died suddenly 39 hours after admission to hospital, with massive blood loss per rectum. At post-mortem examination a saccular cavity containing gallstones was found at the lower end of the common bile duct. The cavity communicated in front with the duodenum and behind with the aorta. This case appears to be the first of its kind to be reported.


Experience with the implantation of atomic pacemakers.


Reviews in cardiology: His bundle electrocardiography.


The in-vitro action of lymphocytes on autologous colon epithelial cells in ulcerative colitis. The action in culture of peripheral blood lymphocytes on autologous large-intestinal epithelial cells was studied in 13 patients with severe mucosal ulcerative colitis. Two different methods were used to measure lymphocyte activity. These showed that autologous-lymphocyte-induced release of isotopic label and detachment in monolayer culture of large-intestinal epithelial cells was increased in acute ulcerative colitis when compared with findings in the same studies in six normal subjects. Subsequently in four of the six patients who responded to cortisone it was shown that lymphocyte activity against epithelial cells returned to the normal range. Further control studies showed little lymphocyte activity against autologous skin and ileum, suggesting that autologous-lymphocyte-induced damage of large-intestinal epithelial cells is a tissue-specific reaction in patients with acute ulcerative colitis. The absence of reactivity in other colonic inflammatory diseases also suggested that such increased in vitro lymphocyte activity is disease-specific for ulcerative colitis.


Nursing: a profession struggling to define itself.


European Regional Organisation.

European Regional Organisation.


Letter: Metronidazole: a possible hazard?


Letter: Oral signs and symptoms in anemias.


Letter: Take thought for the morrow.

Letter: Take thought for the morrow.


Letter: Drug treatments affecting the management of dental patients.


Letter: Elective schemes for dental undergraduates.


Letter: Fluoridation.

Letter: Fluoridation.


Letter: The plain words.

Letter: The plain words.


Letter: Student admissions.

Letter: Student admissions.


Inhalation sedation for conservative dentistry. A comparison between nitrous oxide and methoxyflurane.


Letter: State abuse of dentistry.

Letter: State abuse of dentistry.


Letter: Recommended by the British Dental Association.


Injury to the antrum from use of mouth gag.


Letter: Fluoridation in Cumbria.

Letter: Fluoridation in Cumbria.


Editorial: The first five years.

Editorial: The first five years.


Letter: The accuracy and efficiency of general anesthetic machines in dental practice.


Letter: The Consultative Document--a threat to freedom.


Letter: Caries under composite restorations.


Syneresis in alginate impression materials.


The seal of root fillings at apicectomy. A scanning electron microscope study.


The taper of inlay and crown preparations. A contribution to dental terminology.


Hand-Schüller-Christian disease. Case report with 10-year review.


President's address at the opening of the forty-second session of the General Dental Council.


Anaesthesia for portocaval bypass in patients with metabolic diseases. The biochemical lesions of the glycogen storage diseases and of familial hyperlipidaemia are discussed and the anaesthetic management of patients with these conditions, for the procedure of portocaval bypass, is described.


Letter: A manual ventilation circuit for the Oxford ventilator.


The anatomical and alveolar deadspaces during respirator treatment. Influence of respiratory frequency, minute volume and tracheal pressure. In 10 patients receiving prolonged respirator treatment, respiratory deadspace was measured at 12, 18 and 24 b.p.m. and with two different minute volumes. The physiological deadspace (the sum of apparatus, anatomical and alveolar deadspaces) was derived using the Bohr equation, and the anatomical and alveolar deadspaces were measured by carbon dioxide analysis. Tracheal pressure was measured concurrently. The physiological deadspace to tidal volume ratio was increased on increasing the frequency, and was slightly reduced by an increase in minute volume. The mean values for anatomical deadspace ranged from 144 to 277 ml under the different conditions studied. Neither frequency nor minute volume had any influence on the VD/VT ratio. The volume of the alveolar deadspace was the less than half of the anatomical deadspace. The VD/VT ratio did not vary with frequency or minute volume. A relationship between tracheal end inspiratory pressure and anatomical deadspace was found, with a correlation coefficient of 0.80. The slope of the regression line indicated a high airway compliance of approximately 10 ml/cm H2O.


The attitudes toward alcoholism instrument: a measure of attitudes toward alcoholics and the nature and causes of alcoholism.


Sobriety as a symptom of alcohol intoxication: a clinical commentary on intoxication and drunkenness.


Social class, length of treatment contacts and the outpatient treatment of alcoholism.


Who goes to alcoholic units.

Who goes to alcoholic units.


Aspects of personal relationships in heroin dependent young men--an experimental study.


Characteristics of successful alcoholism treatment programs for American workers.


Family background and personal trauma among drug addicts in the United States: implications for treatment.


Suggestibility in young drug dependent and normal populations.


On understanding and treating narcotic dependence: a neuropsychopharmacological perspective.


Is Australia going to pot: some trends relating to marihuana.


Illegal drug use by Israeli youth.

Illegal drug use by Israeli youth.


Acute promyelocytic leukaemia: haemorrhagic manifestation and morphologic criteria.


Blood leucocyte enzymes. II. Activities at 8-9 a.m. in cells of normal subjects, chronic lymphatic leukaemia and chronic myeloid leukaemia patients. The activities of glucose-6-phosphate dehydrogenase (D-glucose-6-phosphate: NADP oxidoreductase, G6PD), 6-phosphogluconate dehydrogenase (6-phospho-D-gluconate: NADP oxidoreductase, 6PGD), hexokinase (ATP: D-hexose 6-phosphotransferase, Hx), lactate dehydrogenase (D-lactate: NAD oxidoreductase, LDH). glutamate oxaloacetate transaminase (L-aspartate: 2 oxoglutarate aminotransferase, GOT) and dihydrofolate reductase (DHFR) were measured at 8 a.m. in leucocytes of healthy individuals and patients with chronic myeloid leukaemia (CML), chronic lymphatic leukaemia (CLL), myelofibrosis with myeloid metaplasia and polycythaemia vera. In view of the heterogeneity of the leucocyte populations in these conditions, the enzyme activities were correlated to the number of immature cells in CML and to the percentage of lymphocytes in CLL. No differences in the enzyme activities were found between the white cells of healthy individuals, myelofibrosis with myeloid metaplasia and polycythaemia vera. In CML the activities of all enzymes except GOT correlated directly with the number of immature cells; an inverse correlation with the number of lymphocytes was observed in CLL. GOT was the only enzyme whose activity correlated with the number of lymphocytes in the cell suspension. Furthermore, a significantly higher activity of this enzyme was found in Ficoll-isolated CLL lymphocytes as compared to normal lymphocytes.


Leukaemia in children and their grandparents: studies of immune function in six families. Seven of 500 children with acute leukaemia seen over a 15-year period were known to have a close relative with leukaemia or lymphoma. In each case the affected relative was a grandparent of the child, six of the seven being paternal grandparents. Investigation of thses six families showed that the fathers, who had two affected first-degree relatives, had lower lymphocyte counts and higher serum IgA concentrations than paired controls. Atopy, repeated infections and rheumatic disease were common amongst the parents and their sibs. The findings suggest a possible immunodeficiency basis for leukaemia in these families and perhaps also for acute lymphoblastic leukaemia of childhood in general. In the only family in which three generations, including both leukaemic patients, were available for HL-A typing, the affected grandson had not inherited either of his affected grandmother's haplotypes.


Karyotypic abnormalities in transformed chronic granylocytic leukaemia. Chromosomal abnormalities in three cases of chronic granylocytic leukaemia are presented. The relative importance of 'specific' chromosomal abnormalities, additional to the Ph1 in the karyotypic evolution of chronic granylocytic leukaemia is discussed. A new abnormal metacentric chromosome is described.


Dyserythropoiesis and annulate lamellae. Cytoplasmic and intranuclear annulate lamellae in the erythroblasts from patients with dyserythropoietic anaemia (megaloblastic anaemia, dysplastic anaemia and erythroleukaemia) are described. Annulate lamellae have mainly been observed in oocytes, in embryonic tissues and in malignant cells. Their occurrence in dyserythropoietic anaemia may be related to the reappearance of fetal characteristics in the erythroblasts and erythrocytes.


Chronic myelomonocytic leukaemia.

Chronic myelomonocytic leukaemia. The natural history and haematological features of 18 patients with a chronic form of myelomonocytic leukaemia are described. The majority were elderly and, in this series, females predominated. Haematological prodomata, such as unexplained monocytosis, leucopenia, or thrombocytopenia were common, and the clinical onset was insidious. Splenomegaly was variable but tended to increase as the disease progressed. Anaemia was usually less than in the acute disease, unless compounded by iron deficiency. The blood film typically showed a mixed monocytosis and granulocytosis, cells in both lines showing abnormalities. 'Paramyeloid' cells, appearing in Romanowsky stained films intermediate between myelocytes and monocytes, were characteristic, although cytochemical and electron microscopical analysis suggests that these cells may be allotted to one or other cell line. The marrow aspirate was characteristically hypercellular, showed granulocytic hyperplasia, and, in contrast to the well-differentiated blood picture, the proportion of poorly differentiated cells, including blasts, was high. Serum lysozyme levels were usually raised. Five of the 18 cases survived more than 5 years, while 10 lived 2 years or longer. The morphological and clinical features form part of a spectrum including acute myelomonocytic leukaemia, into which several of the patients transformed. Recognition of the syndrome is important because the patients are probably best managed without intensive chemotherapy.


Hypoplastic acute myelogenous leukaemia. The clinical course, diagnosis and management of nine cases of hypoplastic acute myelogenous leukaemia are described. Such cases may follow a slowly progressive course and should not receive anti-leukaemic chemotherapy unless the disease is advancing rapidly or unless some specific complication develops. If chemotherapy has to be given, usually because of severe and recurrent infections, then prompt and prolonged remission of disease may occur.


A comparative study of acute myeloblastic leukaemia in children and adults. The presenting features and clinical course of 89 adults and 15 children with acute myeloblastic leukaemia (AML) presenting to a Regional Leukaemia Centre has been analysed. Remission rate was related to age, being 40% for the total adult group and 60% for all children. Young adults and children had a particularly high remission rate, whilst elderly patients faired badly. Survival diminished with increasing age and patients who entered complete remission survived for a significantly longer time (P less than 0.001) than those who did not. Adult AML differs from childhood AML, the adults having a lower remission rate, a significantly shorter survival (P less than 0.005) and almost complete absence of second remissions. Adults showed no correlation between complete remission and initial WBC or initial blast cell count, but in children there was a significant correlation (P less than 0.05) between initial total WBC and complete remission. A significant correlation between initial platelet count and complete remission could not be demonstrated in either group. Although the numbers of children are small, preadolescent children may represent a favourable sub-group, particularly those between 7 and 8 years of age.


Portal hypertension in chronic leukaemia. Portal haemodynamic studies were carried out in 11 subjects, seven with chronic myeloid leukaemia and four with chronic lymphatic leukaemia, and results compared with those obtained in five patients with 'idiopathic' splenomegaly and with control subjects. All 11 patients with chronic leukaemia had intrasplenic pressures above 11 mmHg and of these four had pressures above 20 mmHg. Portosystemic collaterals were seen on splenovenography in four of these patients. Hepatic vein wedge pressure was above 7 mmHg in nine patients and these high levels were a result of increased free hepatic vein pressure. The corrected sinusoidal pressure and post sinusoidal resistance were essentially normal in all patients. Evidence of increased pre-sinusoidal resistance was seen in six patients. Estimated hepatic blood flow above 1500 ml/min was seen in six patients and all had evidence of histological portal or sinusoidal infilatration. Patients with 'idiopathic' splenomegaly regardless of increased liver blood flow did not have a significant increase in intrasplenic pressure and no alteration in other haemodynamic parameters. It appears that increased liver blood flow alone in a normal liver can only minimally elevate intrasplenic pressure but can play a significant part in the pathogenesis of portal hypertension when liver structure is altered.


The three transcobalamins in myeloproliferative disorders and acute leukaemia. The unsaturated vitamin B12 binding capacity of whole serum (UBBC) and of the three transcobalamins (TC) has been studied in patients with various haematological diseases including myeloproliferative disorders (MPD) and acute leukaemia. The binding capacity of TC I and TC III was increased in MPD; TC I being particularly high in chronic granulocytic leukaemia (CGL) and TC III especially raised in polycythaemia rubra vera (PRV) and in infectious leucocytosis. The binding capacity of both TC I and TC III correlated with blood neutrophil count and the ratio TC III/TC I was low in CGL and increased in PRV. TC II was increased in acute myelogenous leukaemia, during remission and blast cell crisis of CGL and in refractory anaemia with excess of myeloblasts but not in acute lymphoblastic leukaemia (ALL). TC II correlated inversely with blood neutrophil count. There is an inverse ratio between TC II and TC I at least in myelogenous leukaemia. These abnormalities are discussed in relation to granulocyte kinetics. TC III and TC I reflect probably the total body granulocyte pool and share some biochemical and immunological properties supporting the view that they have a common origin in the more mature stages of the granulocyte cell line while TC II probably originates partly in more primitive granulocytes.


The cryosurgery of bone. An experimental and clinical assessment. The histological response of bone to freezing is descirbed and it is suggested that there are three overlapping phases: osteogenic and remodelling. Different methods of freezing bone are evaluated using thermographic data and conclusions are made regarding the clinical application for each in the region of the jaws. The use of cryosurgery is described in the treatment of a group of patients with odontogenic keratocysts. It was used in an attempt to eliminate residual cellular rests and reduce the tendency to recurrence.


Cryosurgery, and its application to oral surgery. The biological mechanisms of tissue necrosis by controlled freezing are discussed, with particular reference to their importance in cryosurgical technique. The clinical events following cryosurgery are decribed, together with common complications. As the oral mucosa is particularly amenable to this form of treatment, it has been used on a wide variety of oral lesions. From observations based on the treatment of over 300 patients, the advantages, disadvantages, relative indications and suitable variations in technique of cryosurgery are discussed.


The management of Ludwig's angina.

The management of Ludwig's angina. A severe case of Ludwig's Angina which was treated along the historical lines of surgical decompression is presented. The problem resulting from this approach are discussed together with alternative methods of management. The conclusion is made that surgical decompression as a means of avoiding respiratory obstruction should be abandoned and that tracheotomy should be used.


The Melkersson-Rosenthal syndrome: a case report.


Goundou--tertiary yaws in the maxilla.

Goundou--tertiary yaws in the maxilla.


Cervico-facial and intra-oral actinomycosis: a 5-year retrospective study. Actinomycosis is often considered to be a rare disease in the oral region. A retrospective study of the Routine Diagnostic Services in Glasgow Dental Hospital revealed 39 cases in which actinomyces were detected, indicating that this organism is not infrequent in oral infections and may be seen in a variety of lesions.


Pigmented villonodular synovitis in the temporomandibular joint: a case report.


Temporomandibular arthrokinetic reflex control of the mandibular musculature. The results of an experimental electromyographic investigation of temporomandibular arthrokinetic reflex control of the mandibular musculature are reported. Co-ordinated, rapidly adapting and slowly adapting facilitatory and inhibitory reflex changes in motor unit activity in the mandibular musculature were evoked by graduated passive movements of the isolated (but innervated) temporomandibular joint. Induced dysfunction of regionally discrete groups of articular mechanoreceptors was shown to result in specific changes in static and dynamic reflex motor unit activity. The possible clinical significance of these changes is discussed.


A new direct resuscitator for use by the dental profession and the emergency services.


Chronic retention.

Chronic retention.


Whose property is a full set of x-rays?

Whose property is a full set of x-rays?


Malpractice--the mess that must be ended.